By Anthony McDaniel, M.D.
Cocaine benzoylmethylecgonine (INN) is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic. Specifically, it is a serotonin–norepinephrine–dopamine reuptake inhibitor, which mediates functionality of these neurotransmitters as an exogenous catecholamine transporter ligand. Because of the way it affects the mesolimbic reward pathway, cocaine is addictive. Its possession, cultivation, and distribution are illegal for non-medicinal and non-government sanctioned purposes in virtually all parts of the world. Although its free commercialization is illegal and has been severely penalized in virtually all countries, its use worldwide remains widespread in many social, cultural, and personal settings. Crack is a lower purity form of free-base cocaine and contains sodium bicarbonate as impurity. Freebase and crack are often administered by smoking. The origin of the name is from the crackling sound (hence the onomatopoeic "crack") produced when cocaine containing impurities are heated.
Cocaine is a powerful nervous system stimulant. Its effects can last from 15–30 minutes to an hour, depending upon the method of ingestion. Cocaine increases alertness, feelings of well-being and euphoria, energy and motor activity, feelings of competence, and sexuality. Athletic performance may be enhanced in sports where sustained attention and endurance is required. Anxiety, paranoia, and restlessness are also frequent. With excessive dosage, tremors, convulsions and increased body temperature are observed. Health problems from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use. Occasional cocaine use does not typically lead to severe or even minor physical or social problems. Cocaine dependence (or addiction) is psychological dependency on the regular use of cocaine. Cocaine dependency may result in physiological damage, lethargy, psychosis, depression, akathisia, and fatal overdose.
Cocaine is the second most popular illegal recreational drug in the U.S. (behind marijuana) and the U.S. is the world's largest consumer of cocaine. Cocaine is commonly used in middle to upper class communities. It is also popular amongst college students, as a party drug. Its users span over different ages, races, and professions. In the 1970s and 80's, the drug became particularly popular in the disco culture as cocaine usage was very common and popular in many discos such as Studio 54. The National Household Survey on Drug Abuse (NHSDA) reported in 1999 that cocaine was used by 3.7 million Americans, or 1.7% of the household population age 12 and older. Estimates of the current number of those who use cocaine regularly (at least once per month) vary, but 1.5 million is a widely accepted figure within the research community. In 2001, more Hispanics received sentences for crimes relating to powder cocaine than any other ethnicity while more African Americans were convicted of crimes relating to crack cocaine in the United States.
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